Provider Demographics
NPI:1114666971
Name:BORGFORD, AVERY ELLE
Entity Type:Individual
Prefix:MS
First Name:AVERY
Middle Name:ELLE
Last Name:BORGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7273 SKAGIT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CONCRETE
Mailing Address - State:WA
Mailing Address - Zip Code:98237-9343
Mailing Address - Country:US
Mailing Address - Phone:206-859-0730
Mailing Address - Fax:
Practice Address - Street 1:7273 SKAGIT VIEW DR
Practice Address - Street 2:
Practice Address - City:CONCRETE
Practice Address - State:WA
Practice Address - Zip Code:98237-9343
Practice Address - Country:US
Practice Address - Phone:206-859-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician